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Audits Offer Fix for Poor Coding Compliance, Lagging Reimbursement

Audits Offer Fix for Poor Coding Compliance, Lagging Reimbursement

THE EVER-INCREASING complexity of healthcare is driving the need for coding quality and compliance programs. Given the transition to ICD-10, advancements in treatments and procedures, a move to quality reporting, and evolving regulations with potentially lofty penalties, the lost reimbursement at stake as the result of poor coding is driving more providers to intensify their coding audit programs.

The trend among large providers is a wave of both random and targeted audits at varying stages of the revenue cycle—from pre-bill to post-bill analysis of key issues ranging from denials to specifics such as transfer DRGs.

Topics: Audit, Health Information Management, Quality

The Future of HIM Quality Audits

5 REASONS WHY CODING & DOCUMENTATION AUDITS ARE MORE IMPORTANT THAN EVER

All health information management (HIM) leaders know that coding quality audits are critical. We can all agree the consequences of substandard coding – lost revenue, increased denials, and greater compliance risk – make the development of a comprehensive coding audit program a priority for healthcare providers of all sizes. Unfortunately, scarce resources and conflicting priorities force many providers to compromise their compliance programs. But now more than ever, audits of coding and documentation quality are critical to the success of healthcare providers.

Topics: ICD-10, Audit, Health Information Management, Quality

Education & Insights from ACDIS 2018

There is no doubt, attendees of last week’s ACDIS 2018 conference will be speaking about it for months to come. The conference was comprised of over 90 speakers including physicians, registered nurses, health information management (HIM) administrators, certified clinical documentation specialists (CDIS) and certified documentation improvement practitioners (CDMP) to name a few. The tracks included something for everyone: Clinical & Coding, Management & Leadership, Quality & Regulatory, Expansion & Innovation, Outpatient and Pediatric. Needless to say, the educational opportunities were vast and it would be nearly impossible to share them all.

Topics: HIM, Health Information Management, CDI, Education

Don’t Be Leery of the Physician Query – 12 Tips to Ensure Your Queries Work

According to AHIMA, a query can be a powerful communication tool used to clarify documentation in the health record and achieve accurate code assignments. Querying has become a common communication and educational tool for clinical documentation improvement (CDI) and coding departments. An effective query process aids the hospital’s compliance with billing/coding rules and serves as an educational tool for providers, CDI professionals, and coding professionals.

Topics: ICD-10, Coding, HIM, CDI, Education, Quality

4 Steps to Finding Work-life Balance When You Work from Home

We all hear a lot about work-life balance, but what does that really mean? To us, it is about daily achievement and enjoyment. It’s about focusing on your achievements and reaching your professional goals, but then having the time to enjoy your life outside of work.

Topics: HIM, Management

CAN YOU CREATE AN INVINCIBLE MEDICAL CODING PROGRAM?

The importance of accuracy and compliance in today's coding environment cannot be overstated. High-quality coding is always a priority – but is there a way to make coding impervious to challenges? Unfortunately, the answer is “NO.”  There is no magic wand that can be waived, spell that can be cast, or cape that you can use to ensure your coding program is invincible.  The fact of the matter is that no two medical records are documented in the same manner and most coding clinics can be interpreted differently.

Topics: Coding, Audit, Education

Podcast: Social Media Tips for HIM Professionals

With more than 17,000 Twitter followers and 30,000 LinkedIn connections, himagine's own Brad Justus knows a thing or two about social media. In this podcast, he shares how he got started with social media and what he has learned about social media through the years:

Topics: HIM, Education, podcast

3 Ways to Support the HIM Profession

As incoming president for the Arizona Health Information Association and after serving on the board for four years, one thing has become clear – AHIMA and its Component State Associations (CSAs) rely on all of us to move the HIM profession into the future.

Topics: HIM

4 focus areas for HCC Clinical documentation improvement (CDI)

In a previous blog post,  More Than Just HCC's: 6 Best Practices for Outpatient CDI, we discussed the areas that need to be addressed in a comprehensive outpatient clinical documentation improvement (CDI) program. While we recommend going beyond just focusing on Hierarchical Condition Categories (HCC’s), taking a closer look at documentation related to HCC’s is a good place to start. Here are four areas where an HCC-focused CDI program can help you optimize revenue, reduce denials, and improve quality.  

Topics: Coding, CDI

Developing Good Manager Employee Relationships in a Remote Environment

I think we can all agree that happy, content employees are more productive and engaged and care about the future of the organization. Direct supervisors can foster a positive work environment by effectively balancing the needs of their employees with those of the organization. But what happens when employees are working remotely and supervisors lose the benefit of developing relationships through face-to-face interactions with their team?

Topics: Management